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Pitfalls in bone density monitoring in prostate cancer during anti-resorptive treatment.
- Source :
-
Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA [Osteoporos Int] 2018 Jul; Vol. 29 (7), pp. 1665-1670. Date of Electronic Publication: 2018 Apr 17. - Publication Year :
- 2018
-
Abstract
- A 74-year-old man presented to the Andrology Clinic for management of potential complications of androgen deprivation therapy for prostate cancer. He had a rising prostate-specific antigen with a concurrent rise in alkaline phosphatase and bone remodeling markers. This was despite treatment with a radical prostatectomy, androgen deprivation, and anti-resorptive therapy. A follow-up dual-energy X-ray absorptiometry scan revealed a marked increase in his bone mineral density at both the lumbar spine and femoral neck. This increase, especially in the context of rising bone remodeling markers, was unlikely due to the effect of anti-resorptive therapy alone. Subsequent whole-body bone scintigraphy demonstrated a "superscan" phenomenon which is characterized by uniform and avid tracer retention throughout the skeleton, in this case due to widespread skeletal metastasis, so that the usual physiological uptake in the kidneys is no longer observed and can be misinterpreted as a "normal" scan if the absence of the kidneys is not recognized. This case highlights the importance of considering diffuse metastatic disease when there is a rapid increase in bone mineral density, even in individuals treated with anti-resorptive therapy.
- Subjects :
- Absorptiometry, Photon methods
Aged
Androgen Antagonists adverse effects
Bone Neoplasms diagnostic imaging
Bone Neoplasms physiopathology
Bone Neoplasms secondary
Femur Neck physiopathology
Humans
Lumbar Vertebrae physiopathology
Male
Osteoporosis chemically induced
Osteoporosis physiopathology
Prostatectomy
Radionuclide Imaging
Bone Density physiology
Bone Density Conservation Agents therapeutic use
Osteoporosis diagnostic imaging
Prostatic Neoplasms drug therapy
Prostatic Neoplasms physiopathology
Subjects
Details
- Language :
- English
- ISSN :
- 1433-2965
- Volume :
- 29
- Issue :
- 7
- Database :
- MEDLINE
- Journal :
- Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA
- Publication Type :
- Academic Journal
- Accession number :
- 29666893
- Full Text :
- https://doi.org/10.1007/s00198-018-4481-1